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Balance problems

Expert diagnosis, treatment and management of balance problems and dizziness

clinician holding hands of elder patient holding onto to walking aid
Balance problems, also known as balance disorders, make you feel dizzy or unsteady. They can affect your walking and your co-ordination, making you feel unsteady, or uncertain in your movements. You might feel light-headed or as if the room is spinning, and this can happen whether you're sitting, lying down or standing.

Balance problems and dizziness are more common than you might think. In the UK alone, thousands of people struggle with these issues daily, impacting their quality of life and limiting their ability to engage in activities they enjoy.

Balance problems become more common as we get older, with more than 30% of people over 65 experiencing a fall each year. But people of any age can be affected, and there are various underlying causes that are unrelated to age.

Balance problems can be caused by a variety of conditions, from inner ear problems to neurological events, and they can also come on as a result of certain medications, or after an illness or an injury. It can be difficult to diagnose the causes of your balance disorder, and often you'll need the help of a specialist to correctly identify the root cause in order to be able to treat it.

At Circle Health Group, we take a multidisciplinary approach to diagnosing and managing balance disorders, making sure you have access to all the specialist help you need. For more information or to book an appointment with a specialist, call or book online today.

Dizziness and vertigo are both symptoms related to a person's perception of balance and spatial orientation, but they have distinct characteristics that set them apart.


Dizziness is a broad term used to describe a range of sensations related to unsteadiness, disorientation, and a feeling of altered spatial awareness. People who experience dizziness might describe it as feeling lightheaded, woozy, or off-balance.

Dizziness can be caused by various factors, including inner ear problems, dehydration, low blood pressure, medication side effects, anxiety, and more. It's a subjective sensation and can manifest differently from person to person.


Vertigo is a specific type of dizziness characterized by a false sense of rotational movement, either of the person or their surroundings. It often feels like the world is spinning or moving, even when the person is stationary. Vertigo is most commonly associated with issues in the inner ear, particularly the vestibular system, which plays a crucial role in maintaining balance. Conditions like benign paroxysmal positional vertigo (BPPV), Meniere's disease, and vestibular migraines can cause vertigo.

In summary, while both dizziness and vertigo involve feelings of imbalance and altered spatial perception, vertigo specifically entails a spinning or rotational sensation. Dizziness, on the other hand, is a broader term encompassing various sensations of unsteadiness or disorientation. If you're experiencing persistent dizziness or vertigo, it's essential to seek medical evaluation to determine the underlying cause and receive appropriate treatment.

Other symptoms of balance problems

Dizziness and vertigo are the most common symptoms of balance problems, and they can be accompanied by any or all of the below. It is also possible to experience the below symptoms due to a balance disorder even if you don't show typical signs of dizziness or vertigo.

  • Nausea or vomiting
  • Unsteadiness or disequilibrium
  • Leaning or veering to one side when walking
  • Fullness in the ears
  • Fluctuating hearing loss
  • Difficulties in crowded or busy environments
  • Repeated light-headedness
  • Spinning sensations or vertigo
  • Floating sensations
  • Sensations of being pushed or pulled
  • Blurred or double vision
  • Feeling confused or unable to coordinate movements
  • Brain fog
  • Anxiety or panic attacks
  • Headaches or migraines
  • Increased sensitivity to light and sound
  • Motion sickness
  • Neck pain
  • Tinnitus

Balance disorders can originate from various sources, including:

Inner ear issues

Problems with the inner ear, such as Meniere's disease or benign paroxysmal positional vertigo (BPPV), can lead to vertigo and dizziness.

Neurological conditions

Certain neurological disorders like vestibular migraines or multiple sclerosis can affect your body's sense of balance.


Some medications have the potential to disrupt your balance system, leading to dizziness and unsteadiness.

Age-related changes

As we age, our balance systems can naturally decline, making us more susceptible to balance issues.

Injury or trauma

Head injuries or trauma can damage the inner ear or affect the brain's processing of balance signals.

Many of our ENT surgeons offer a specific primary assessment for balance problems, designed to uncover the root causes even of non-specific symptoms, providing a clear roadmap for your recovery.

This assessment is a multi-faceted approach that combines advanced diagnostic techniques and specialised expertise to ensure a thorough understanding of your condition.

Typically, you will start with a formal assessment by your ENT consultant, where they will gather crucial insights into your medical history, symptoms, and overall health.

Next, a specialist audiologist might conduct vestibular tests to assess the function of your inner ear and the pathways responsible for balance. You might also meet with a specialist vestibular physiotherapist, who can assess your physical condition and guide you through exercises and techniques that aim to improve your balance and minimize dizziness.

Common tests for balance problems

During your primary assessment your doctor may perform one or more of the following tests:

Video head impulse test

This advanced test evaluates the function of your vestibular system by tracking your eye movements in response to head movements.

Modified clinical test of sensory integration of balance

A comprehensive test to assess how different sensory inputs affect your balance.

Blood pressure testing

Ensuring a holistic assessment by considering potential cardiovascular factors.

Benign paroxysmal positional vertigo evaluation

Identifying the presence of BPPV, a common cause of vertigo and dizziness.

Cervical spine test

Exploring the connection between your neck and balance.

Falls risk/walking assessment

Evaluating your risk of falls and your overall walking patterns.

Personalised care and follow-up

Soon after your assessment, you will receive a telephone follow-up from the consultant ENT surgeon. This call will provide you with a detailed report, including the results of your tests, recovery plans, and recommended treatment options. Often you will have a course of vestibular physiotherapy. If necessary, prescriptions will also be discussed.

Our comprehensive primary assessment is the first step toward understanding your condition and regaining control over your life. Whether it's through state-of-the-art testing, expert consultations, or personalised rehabilitation, we're here to guide you every step of the way.

If your initial assessment indicates that your balance disorder is a more complex case, our multidisciplinary teams can provide an advanced assessment, making the most of our cutting-edge diagnostic technology.

This might include:

MRI Scan

An MRI scan will provide a comprehensive view of the structures within your head and neck, aiding in uncovering potential underlying causes.

Videonystagmography (VNG)

This advanced test analyses your eye movements during specific head and body movements, helping us understand how your vestibular system functions.

Bi-thermal Caloric Testing

By stimulating the inner ear with temperature changes, we can further assess the functionality of your vestibular system.

Vestibular-Evoked Myogenic Potentials (VEMPs)

These tests measure the muscle responses in your neck and face, providing insights into the health of your inner ear.

Typically, treatment for balance problems will be non-invasive. Our recommendation for these non-surgical treatments vary based on what is causing your symptoms, for example:

  • Medication helps relieve various symptoms
  • Vestibular rehabilitation (vestibular therapy) involves balance exercises to help you adjust your balance problems and maintain physical activity
  • Positioning techniques remove particles from the inner ear

Treatment will vary from person to person depending on various factors including the underlying causes of your balance problems as well as your personal circumstances. Every treatment plan will be individually tailored to your individual needs.

Balance issues can be elusive and complex, often presenting symptoms that overlap with other conditions. This complexity makes it challenging to pinpoint the exact cause during a standard GP visit. As a result, many individuals find themselves facing prolonged uncertainty and frustration as they search for answers.

Because of this, we recommend speaking to a specialist. At Circle Health Group, you can book directly with a consultant of your choice. If you don't have a GP referral, give us a call and we'll let you know whether it's needed. If so, we offer fast access to virtual private GPs who offer referrals.

Healthcare specialists who can help with balance problems:

  • Ear, nose and throat surgeon - specialised in diseases in the ears, nose, neck, and throat. They may perform a hearing examination
  • Audiologist - specialised in inner-ear problems, which may be a cause of dizziness. They will assess your balance and check for any balance disorders
  • Physiotherapist in vestibular rehabilitation, balance and other neurological disorders

When you choose to go private with Circle Health Group, you can expect:

  • Flexible appointment times and locations to fit your routine
  • The freedom to choose which hospital and consultant suit your needs
  • Personalised, consultant-led treatment plans tailored to your individual needs
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams
  • Private ensuite rooms as standards and delicious healthy meals
  • Affordable, fixed-price packages with aftercare included
  • Flexible payment options to help you spread the cost of your care

If you would like to learn more about this procedure, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in September 2023. Next review due September 2026.

  1. Balance disorders, National Institute on Deafness and Other Communication Disorders
  2. Balance problems, Mayo Clinic
  3. Dizziness and balance problems, Brain and Spine Foundation
  4. Physical activity programs for balance and fall prevention in elderly, NCBI
  5. Common balance disorders, NHS

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